Meghann Rose Peterson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20969 Issued in MN

Practice address

1100 Glenwood Ave
Minneapolis, MN 55405-1430

Phone

(612) 871-1454

Fax

(612) 871-1505

NPI assigned

Mar 6, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Meghann Rose Hartman Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Washburn Center for Children

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1225136419
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1053737684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051430",
            "telephone_number": "612-871-1454",
            "fax_number": "612-871-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051430",
            "telephone_number": "612-871-1454",
            "fax_number": "612-871-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MEGHANN",
        "middle_name": "ROSE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-06",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGHANN",
            "last_name": "HARTMAN",
            "middle_name": "ROSE",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Linda Marie Peterson
• Lindsey Peterson, OT
• Louise Ballam Peterson
• Marie Elizabeth Peterson, M.D.
• Matthew D Peterson, L.AC., DIPL. OM
• Michelle D Peterson, DPT, NCS
• Molly Peterson, LICSW
• Nancy Carolyn Peterson, LICSW
• Phillip K Peterson, MD
• Randy Wayne Peterson, APRN, CNP

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.